Kim NH, et al. - In this cross-sectional study, researchers assessed the association of urinary cotinine-verified smoking status with the risk of colorectal neoplasia (CRN). Participants in the study were 96,806 asymptomatic examinees who had a colonoscopy and urinary cotinine measurements as part of a health check-up. Investigators found that the mean participant age was 38.4 years and the proportion of cotinine-verified current smokers was 23.0%. An independent risk factor for CRN and advanced CRN (ACRN) was cotinine-verified current smoking. According to findings cotinine-captured smoking status and metabolic variation show associations with CRN more precisely and objectively than self-reporting does, giving clearer evidence for the role of tobacco in the development of CRN.